Open AccessRenin angiotensin system: A novel target for migraine prophylaxis
Author(s) -
Ruchika Nandha,
Harpal Singh
Publication year - 2012
Publication title -
indian journal of pharmacology/the indian journal of pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.286
H-Index - 59
eISSN - 1998-3751
pISSN - 0253-7613
DOI - 10.4103/0253-7613.93840
Subject(s) - triptans , migraine , medicine , drug class , headaches , population , adverse effect , angiotensin receptor blockers , pharmacology , acute migraine , intensive care medicine , drug , angiotensin converting enzyme , anesthesia , blood pressure , alternative medicine , surgery , placebo , environmental health , pathology
Migraine constitutes 16% of primary headaches affecting 10-20% of general population according to International Headache Society. Till now nonsteroidalanti-inflammatory drugs (NSAIDS), opioids and triptans are the drugs being used for acute attack of migraine. Substances with proven efficacy for prevention include β-blockers, calcium channel blockers, antiepileptic drugs and antidepressants. All the already available drugs have certain limitations. Either they are unable to produce complete relief or 30-40% patients are no responders or drugs produce adverse effects. This necessitates the search for more efficacious and well-tolerated drugs. A new class of drugs like angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin II receptor antagonists have recently been studied for their off label use in prophylaxis of migraine. Studies, done so far, have shown results in favour of their clinical use because of the ability to reduce number of days with headache, number of days with migraine, hours with migraine, headache severity index, level of disability, improved Quality of life and decrease in consumption of specific or nonspecific analgesics. This article reviews the available evidence on the efficacy and safety of these drugs in prophylaxis of migraine and can give physician a direction to use these drugs for chronic migraineurs. Searches of pubmed, Cochrane database, Medscape, Google and clinicaltrial.org were made using terms like ACE inhibitors, angiotensin II receptor antagonists and migraine. Relevant journal articles were chosen to provide necessary information.